来氟米特治疗系统性红斑狼疮的临床疗效及对血清BAFF MCP-4 IL-8 IL-10水平的影响

doi:10.3969/j.issn.1006-6233.2018.12.006

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摘要 目的: 探讨来氟米特治疗系统性红斑狼疮的临床疗效、安全性及对血清B细胞活化因子(BAFF)、单核细胞趋化蛋白(MCP-4)、白介素(IL-8)、白介素(IL-10)水平的影响。方法: 选择2014年9月至2016年9月我院接诊的96例系统性红斑狼疮患者,通过简单随机数表法分为观察组(n=48)和对照组(n=48)。对照组给予常规糖皮质素治疗,观察组联合应用来氟米特,连续用药半年。比较两组临床疗效、治疗前后24h尿蛋白、疾病活动指数(SLEDAI)评分、血清BAFF、MCP-4、IL-8、IL-10水平的变化及不良反应的发生情况。结果: 治疗后,观察组临床疗效总有效率明显高于对照组(P<0.05)。治疗前,两组24h尿蛋白、SLEDAI评分、血清BAFF、MCP-4、IL-8、IL-10比较差异均无统计学意义(P>0.05);治疗后,两组24h尿蛋白、SLEDAI评分、血清BAFF、MCP-4、IL-8、IL-10水平均较治疗前显著改善(P<0.05),且观察组24h尿蛋白、SLEDAI评分、血清BAFF、MCP-4、IL-8、IL-10均明显低于对照组,差异均具有统计学意义(P<0.05)。此外,观察组不良反应总发生率明显低于对照组(P<0.05)。结论: 氟米特治疗系统性红斑狼疮患者的临床效果显著,其作用机制可能与有效降低血清BAFF、MCP-4、IL-8、IL-10的表达有关。

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关键词 ：系统性红斑狼疮, 来氟米特, B细胞活化因子, 单核细胞趋化蛋白-4, 白介素-8, 白介素-10

Abstract：Objective: To investigate the clinical efficacy and safety of leflunomide in the treatment of systemic lupus erythematosus (SLE) and its effects on serum levels of B cell activating factor (BAFF), monocyte chemoattractant protein (MCP-4), interleukin-8 (IL-8) and interleukin-10 (IL-10). Methods: 96 patients with systemic lupus erythematosus admitted to our hospital from September 2014 to September 2016 were selected. According to the simple random number table, all the patients were divided into the observation group (n=48) and the control group (n=48). The control group was treated with glucocorticoid, while the observation group was treated with leflunomide. Then the clinical effect, the changes of 24 h urinary protein, SLEDAI scores, serum levels of BAFF, MCP-4, IL-8 and IL-10, and the incidence of adverse reactions in the two groups before and after treatment were observed and compared between the two groups. Results: After treatment, the total effective rate of observation group was significantly higher than that of the control group (P＜0.05). Before treatment, there was no significant difference in the 24h urinary protein, SLEDAI score, serum BAFF, MCP-4, IL-8 and IL-10 levels between the two groups (P＞0.05); after treatment, the 24h urinary protein, SLEDAI score, serum BAFF, MCP-4, IL-8 and IL-10 of the two groups were significantly improved compared to those before treatment (P＜0.05), the 24h urinary protein, SLEDAI scores, serum BAFF, MCP-4, IL-8 and IL-10 levels of observation group were significantly lower than those of the control group (P＜0.05); the incidence of adverse reactions in the observation group was significantly lower than that of the control group (P＜0.05). Conclusion: Leflunomide can enhance the clinical efficacy in the treatment of systemic lupus erythematosus, which may be related to the inhibition of serum BAFF, MCP-4, IL-8 and IL-10 levels.

Key words： Systemic lupus erythematosus Leflunomide B cell activating factor Monocyte chemotaxis protein-4 Interleukin-8 interleukin-10

基金资助:青海省自然科学基金,(编号:2013Z0198)

通讯作者: 陶东红

引用本文:

吴文英,陶东红,张如峰,马凤英,包淑珍,李赟,张海生,王倩. 来氟米特治疗系统性红斑狼疮的临床疗效及对血清BAFF MCP-4 IL-8 IL-10水平的影响[J]. 河北医学, 2018, 24(12): 1957-1959.
WU Wenying, TAO Donghong, ZHANG Rufeng, et al. Curative Efficacy of Leflunomide in Treatment of Systemic Lupus Erythematosus and Effects on Serum BAFF MCP-4 IL-8 and IL-10 Levels. HeBei Med, 2018, 24(12): 1957-1959.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.12.006 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I12/1957

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